Pre-pregnaney evaluation and management of scarred uterus re-pregnancy

doi:10.3877/cma.j.issn.2095-3259.2025.01.003

Abstract

Abstract:

This article comprehensively examines prenatal assessment and treatment strategies for re-pregnancy in the context of a scarred uterus. It underscores the significance of accurately evaluating the healing status of uterine scars and proposes a series of pre-pregnancy assessment methods and treatment interventions. The discussion delves into the various factors influencing scar healing following cesarean sections and myomectomies， and recommends corresponding assessment techniques， including transvaginal ultrasound， hysteroscopic contrast ultrasound， magnetic resonance imaging， and hysteroscopy.Furthermore， the article introduces a clinical grading system for cesarean scar diverticulum， which is a valuable reference for clinical decision-making. Additionally， it offers suggestions for the surgical management of poorly healing cesarean scars.

Key words: Uterus, Cicatrix, Cesarean section, Uterine myomectomy, Diverticulum, Preconception care

Zhangxin Wu, Yu Wu. Pre-pregnaney evaluation and management of scarred uterus re-pregnancy[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2025, 14(01): 8-14.

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URL: https://zhckjjdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3259.2025.01.003

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References 37

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剩余子宫肌层厚度	≤2. 2 mm 为3 分，＞2. 5 mm 为1 分
残存肌层百分比	＜20%为3 分，20% ～50%为2 分；＞50%为1 分
子宫瘢痕憩室数量	1 个为0 分，＞1 个为1 分
剖宫产次数	1 次为0 分，＞1 次为1 分
月经情况	正常为0 分，异常为1 分
分级：Ⅰ级（轻度）2 ～3 分；Ⅱ级（中度）4 ～6 分；Ⅲ级（重度）7 ～9 分

剩余子宫肌层厚度	≤2. 2 mm 为3 分，＞2. 5 mm 为1 分
残存肌层百分比	＜20%为3 分，20% ～50%为2 分；＞50%为1 分
子宫瘢痕憩室数量	1 个为0 分，＞1 个为1 分
剖宫产次数	1 次为0 分，＞1 次为1 分
月经情况	正常为0 分，异常为1 分
分级：Ⅰ级（轻度）2 ～3 分；Ⅱ级（中度）4 ～6 分；Ⅲ级（重度）7 ～9 分

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